A framework for research into continental ancestry groups of the UK Biobank

The UK Biobank is a large prospective cohort, based in the United Kingdom, that has deep phenotypic and genomic data on roughly a half a million individuals. Included in this resource are data on approximately 78,000 individuals with "non-white British ancestry". Whilst most epidemiology studies have focused predominantly on populations of European ancestry, there is an opportunity to contribute to the study of health and disease for a broader segment of the population by making use of the UK Biobank's "non-white British ancestry" samples. Here we present an empirical description of the continental ancestry and population structure among the individuals in this UK Biobank subset. Reference populations from the 1000 Genomes Project for Africa, Europe, East Asia, and South Asia were used to estimate ancestry for each individual. Those with at least 80% ancestry in one of these four continental ancestry groups were taken forward (N=62,484). Principal component and K-means clustering analyses were used to identify and characterize population structure within each ancestry group. Of the approximately 78,000 individuals in the UK Biobank that are of "non-white British" ancestry, 50,685, 6,653, 2,782, and 2,364 individuals were associated to the European, African, South Asian, and East Asian continental ancestry groups, respectively. Each continental ancestry group exhibits prominent population structure that is consistent with self-reported country of birth data and geography. Methods outlined here provide an avenue to leverage UK Biobank's deeply phenotyped data allowing researchers to maximise its potential in the study of health and disease in individuals of non-white British ancestry.

Evaluating a polygenic hazard score to predict risk of developing metastatic or fatal prostate cancer in the multi-ancestry Million Veteran Program cohort

Importance: Early detection of prostate cancer to reduce mortality remains controversial because there is often also overdiagnosis of low-risk disease and unnecessary treatment. Genetic scores may provide an objective measure of a man's risk of dying from prostate cancer and thus inform screening decisions, especially in men of African ancestry, who have a higher average risk of prostate cancer death but are often treated as a homogeneous group. Objective: Determine whether a polygenic hazard score based on 290 genetic variants (PHS290) is associated with risk of metastatic or fatal prostate cancer in a racially and ethnically diverse population. Design: Million Veteran Program (MVP) cohort study, 2011-2021. Setting: Nation-wide study of United States military veterans. Participants: Population-based volunteer sample of male participants. Exposure(s): Genotype data were used to calculate the genetic score, PHS290. Family history of prostate cancer and ancestry group (harmonized genetic ancestry and self-reported race/ethnicity: European, African, Hispanic, or Asian) were also studied. Main Outcome(s) and Measure(s): Study designed after MVP data collected. Primary outcome: age at death from prostate cancer. Key secondary outcome: age at diagnosis of prostate cancer metastases. Hypothesis: A germline genetic score (PHS290) is associated with risk of fatal (or metastatic) prostate cancer. Results: 513,997 MVP participants were included. Median age at last follow-up: 69 years. PHS290 was associated with age at death from prostate cancer in the full cohort and for each ancestry group (p<1e-16). Comparing men in the highest 20% of PHS290 to those in the lowest 20%, the hazard ratio for death from prostate cancer was 4.41 [95% CI: 3.9-5.02]. Corresponding hazard ratios for European, African, Hispanic, and Asian subsets were 4.26 [3.66-4.9], 2.4 [1.77-3.23], 4.72 [2.68-8.87], and 10.46 [2.01-101.0]. When accounting for family history and ancestry group, PHS290 remained a strong independent predictor of fatal prostate cancer. PHS290 was also associated with metastasis. PHS290 was higher, on average, among men with African ancestry. Conclusions and Relevance: PHS290 stratified US veterans of diverse ancestry for lifetime risk of metastatic or fatal prostate cancer. Predicting genetic risk of lethal prostate cancer with PHS290 might inform individualized decisions about prostate cancer screening.

Cartilha para enfrentamento do COVID-19 em comunidades quilombolas: relato de experiência

O estudo objetivou relatar a experiência de elaboração de uma cartilha educativa sobre o enfrentamento ao Covid-19 para Comunidades Remanescentes de Quilombos (CRQ). Trata-se de um estudo qualitativo do tipo metodológico, realizado em maio de 2020, a partir das etapas: 1) aprofundamento teórico sobre o COVID-19; 2) estruturação do roteiro; e 3) elaboração do layout por um designer gráfico. A cartilha desenvolvida de forma interativa, oferece informações para prevenção da disseminação do coronavírus junto às comunidades quilombolas, por meio da técnica de lavagem das mãos e do uso correto da máscara facial. Aborda ainda, algumas técnicas de relaxamento, alongamento e automassagem no controle do estresse e da ansiedade no período de isolamento social. Essa tecnologia educativa constituiu uma estratégia valiosa no enfrentamento da pandemia pelo COVID-19, com orientações e informações capazes de auxiliar na prevenção e no controle emocional, respeitando-se o contexto sociocultural do povo quilombola.Descritores: Grupo com Ancestrais do Continente Africano, Tecnologia Educacional, Educação em Saúde, Infecções por Coronavírus. COVID-19 facing letter in quilombola communities: experience reportAbstract: This study aimed to report the experience of developing an interactive facing letter about the confrontation of COVID-19 for remaining Quilombola Communities (CRQ).This is a qualitative study of methodological approach, carried out in May 2020, based on the following steps: 1) theoretical deepening on COVID-19; 2) structuring the script; and 3) layout elaboration by a graphic designer. The booklet interactively developed provides information to prevent the spread of coronavirus in quilombola communities, through the hand-washing technique and the correct use of the face mask. It also addresses some relaxation, stretching, and self-massage techniques for controlling stress and anxiety during the period of social isolation. This educational technology constituted a valuable strategy for coping with the COVID-19 pandemic, with useful guidelines and information to assist in the prevention and emotional control, respecting the socio-cultural context of the quilombola people.Descriptors: African Continental Ancestry Group, Educational Technology, Health Education, Coronavirus Infections. Carta frente al COVID-19 en comunidades quilomball: informe de experienciaResumen: El estudio objetivó relatar la experiencia de desarrollo de cartilla sobre cómo enfrentar a la COVID-19 para Comunidades Restantes de Quilombos (RCQ). Metodología: estudio cualitativo, del tipo metodológico, realizado en mayo de 2020, en las fases: 1) profundización teórica sobre COVID-19; 2) estructuración de la cartilla; y 3) elaboración del diseño por diseñador gráfico. Resultados: cartilla desarrollada de manera interactiva, con información para prevenir la propagación del coronavirus a las comunidades quilombolas, a través de la técnica de lavado de manos y el uso correcto de la máscara facial. También aborda algunas técnicas de relajación, estiramiento y automasaje para controlar el estrés y la ansiedad durante el aislamiento social. Consideraciones finales: esta tecnología educativa constituyó estrategia valiosa para hacer frente a la pandemia de COVID-19, con orientaciones e informaciones capaces de ayudar en la prevención y control emocional, respetando el contexto sociocultural de la población quilombola.Descriptores: Grupo de Ascendencia Continental Africana, Tecnología Educacional, Educación en Salud, Infecciones por Coronavirus.

Cartilha para enfrentamento do COVID-19 em comunidades quilombolas: relato de experiência

O estudo objetivou relatar a experiência de elaboração de uma cartilha educativa sobre o enfrentamento ao Covid-19 para Comunidades Remanescentes de Quilombos (CRQ). Trata-se de um estudo qualitativo do tipo metodológico, realizado em maio de 2020, a partir das etapas: 1) aprofundamento teórico sobre o COVID-19; 2) estruturação do roteiro; e 3) elaboração do layout por um designer gráfico. A cartilha desenvolvida de forma interativa, oferece informações para prevenção da disseminação do coronavírus junto às comunidades quilombolas, por meio da técnica de lavagem das mãos e do uso correto da máscara facial. Aborda ainda, algumas técnicas de relaxamento, alongamento e automassagem no controle do estresse e da ansiedade no período de isolamento social. Essa tecnologia educativa constituiu uma estratégia valiosa no enfrentamento da pandemia pelo COVID-19, com orientações e informações capazes de auxiliar na prevenção e no controle emocional, respeitando-se o contexto sociocultural do povo quilombola.Descritores: Grupo com Ancestrais do Continente Africano, Tecnologia Educacional, Educação em Saúde, Infecções por Coronavírus. COVID-19 facing letter in quilombola communities: experience reportAbstract: This study aimed to report the experience of developing an interactive facing letter about the confrontation of COVID-19 for remaining Quilombola Communities (CRQ).This is a qualitative study of methodological approach, carried out in May 2020, based on the following steps: 1) theoretical deepening on COVID-19; 2) structuring the script; and 3) layout elaboration by a graphic designer. The booklet interactively developed provides information to prevent the spread of coronavirus in quilombola communities, through the hand-washing technique and the correct use of the face mask. It also addresses some relaxation, stretching, and self-massage techniques for controlling stress and anxiety during the period of social isolation. This educational technology constituted a valuable strategy for coping with the COVID-19 pandemic, with useful guidelines and information to assist in the prevention and emotional control, respecting the socio-cultural context of the quilombola people.Descriptors: African Continental Ancestry Group, Educational Technology, Health Education, Coronavirus Infections. Carta frente al COVID-19 en comunidades quilomball: informe de experienciaResumen: El estudio objetivó relatar la experiencia de desarrollo de cartilla sobre cómo enfrentar a la COVID-19 para Comunidades Restantes de Quilombos (RCQ). Metodología: estudio cualitativo, del tipo metodológico, realizado en mayo de 2020, en las fases: 1) profundización teórica sobre COVID-19; 2) estructuración de la cartilla; y 3) elaboración del diseño por diseñador gráfico. Resultados: cartilla desarrollada de manera interactiva, con información para prevenir la propagación del coronavirus a las comunidades quilombolas, a través de la técnica de lavado de manos y el uso correcto de la máscara facial. También aborda algunas técnicas de relajación, estiramiento y automasaje para controlar el estrés y la ansiedad durante el aislamiento social. Consideraciones finales: esta tecnología educativa constituyó estrategia valiosa para hacer frente a la pandemia de COVID-19, con orientaciones e informaciones capaces de ayudar en la prevención y control emocional, respetando el contexto sociocultural de la población quilombola.Descriptores: Grupo de Ascendencia Continental Africana, Tecnología Educacional, Educación en Salud, Infecciones por Coronavirus.

Estilo de vida da população afrodescendente: revisão integrativa / Afro-descendant population lifestyle: integrative review

Objetivo: identificar, por meio de uma revisão integrativa, como os artigos científicos publicados no período de 2014 a 2016 se relacionam ao estilo de vida da população afrodescendente. Método: revisão integrativa em artigos publicados no período de 2014 a 2016, com a combinação African continental ancestry group AND Life style, em seis bases de dados. Resultados: localizou-se 318 artigos, e 20 artigos foram selecionados, que tratam de estudos realizados nos Estados Unidos; pesquisa transversal; atividade física como variável do estilo de vida mais estudada; e trabalhou com duas ou mais divisões de etnias. Conclusões: nenhum estudo pesquisou as dimensões atividade física, nutrição, controle do estresse, comportamentos preventivos e relacionamentos simultâneamente. Assim, ampliar as pesquisas com mais dimensões do estilo de vida pode fornecer mais informações aos profissionais que atuam na assistência à saúde, e contribuir na criação e reformulação de ações e políticas de saúde.

Variable prediction accuracy of polygenic scores within an ancestry group

Fields as diverse as human genetics and sociology are increasingly using polygenic scores based on genome-wide association studies (GWAS) for phenotypic prediction. However, recent work has shown that polygenic scores have limited portability across groups of different genetic ancestries, restricting the contexts in which they can be used reliably and potentially creating serious inequities in future clinical applications. Using the UK Biobank data, we demonstrate that even within a single ancestry group (i.e., when there are negligible differences in linkage disequilibrium or in causal alleles frequencies), the prediction accuracy of polygenic scores can depend on characteristics such as the socio-economic status, age or sex of the individuals in which the GWAS and the prediction were conducted, as well as on the GWAS design. Our findings highlight both the complexities of interpreting polygenic scores and underappreciated obstacles to their broad use.

The lesbian, gay, bisexual and transgender movement: A systematic review with meta-analysis

Background: To identify, through the conscientious, explicit and judicious use, the evidence about health behaviors and situations included in the decision making on individuals belonging to the lesbian, gay, bisexual and transgender (LGBT) group in the context of ethnic disparities and sexual minorities. Methods: A systematic review with meta-analysis meta-synthesis from searches in electronic databases SCOPUS and Virtual Health Library (VHL), portal that hosts databases such as MEDLINE, using the following descriptors MeSH (Medical Subject Headings): ‘Sexual Minorities’, ‘Health’, ‘African Continental Ancestry Group’ and ‘Brazil’. To achieve safe and reproducible research, the authors decided to gather the descriptors using Boolean operators AND and OR, in the following manner: in the VHL, Sexual Minorities AND Health AND African Continental Ancestry Group OR Brazil; in SCOPUS, Sexual Minorities AND Health AND African Continental Ancestry Group. The selection of articles occurred in two stages. Results: Of the 52 results found, this study included 14 articles, according to the stages of screening and eligibility criteria. The research carried out proved to be scarce when related to Brazil, so that the review was constructed from studies carried out in international environment. Conclusion: The scarcity of studies in this area suggested lack of knowledge on the health profiles of the LGBT Afro Population. The individualized attention proved to be insufficient and reveals the need for training health professionals aware of the aspects and health care for this population, with a view to implementing integral health policies that already exist.

Variable prediction accuracy of polygenic scores within an ancestry group

Fields as diverse as human genetics and sociology are increasingly using polygenic scores based on genome-wide association studies (GWAS) for phenotypic prediction. However, recent work has shown that polygenic scores have limited portability across groups of different genetic ancestries, restricting the contexts in which they can be used reliably and potentially creating serious inequities in future clinical applications. Using the UK Biobank data, we demonstrate that even within a single ancestry group, the prediction accuracy of polygenic scores depends on characteristics such as the age or sex composition of the individuals in which the GWAS and the prediction were conducted, and on the GWAS study design. Our findings highlight both the complexities of interpreting polygenic scores and underappreciated obstacles to their broad use.